Pulmonary aspergilloma is by no means uncommon in Malaysia. The lack of documentation of its occurrence in Malaysia, is mainly due to the lack of clinical awareness, and the absence of facilities for the proper diagnosis of the infection.
The clinical syndrome of dialysis encephalopathy which has been observed all over the world has also been seen here. The clinical syndrome and clinical course are reported; it has been associated with high levels of aluminium in untreated water used for haemodialysis. Since the introduction of water treatment, this disease has not been observed.
594 intravenous urograms done at the General Hospital, Ipoh, from January 1981 to March 1985 were reviewed for renal papillary necrosis (RPN). 11 cases (1.8%) of RPN were detected. Of these three were due to diabetes mellitus;eight were due to analgesic nephropathy. There was an equal incidence
in males and females, contrary to the experience in the West and Australia. RPN was observed mainly in the older age groups. Five of the 11 cases of RPN presented as renal colic.
55% of a sample of patients in a rural
community, and 76% of a sample of patients and
staff in the local district hospital were found to
be nasal carriers for Staphylococcus aureus. The
in vitro antibiotic susceptibility patterns of 46
strains of S. aureus isolated in nasal carriers as
well as of 43 strains in community-acquired skin
infections were characterised. High levels of
resistance were expressed to penicillin (73%),
cephalexin (64%) and tetracycline (46%).
Resistance to erythromycin (18%) was moderate.
A few strains showed resistance to methicillin
(5 isolates), vancomycin (4), [usidic acid (3),
cotrimoxazole (1), and none to gentamicin.
Penicillin can no longer be recommended for
treating community-acquired S. aureus infections.
A preliminary report on the short-term use of Tioconazole for vaginal candidiasis is presented. The cure rate was found to be approximately 90% in mild degrees of the disease, with good patient compliance and minimal side effects. However no conclusion can be drawn for moderate or severe cases of the condition.
A retrospective study of 37 intraocular foreign bodies treated over a five-year period is presented. Their aetiology, complications and visual results are discussed in the light of recent development in the management of serious ocular trauma.
Study site: Hospital Kuala Lumpur, Malaysia (UKM unit)
Raised intraocular pressure (lOP) is generally held responsible for causing visual loss in chronic simple glaucoma. It is therefore desirable that a safe level of lOP be maintained all the time. Elevation of lOP with change of body position has been suggested as one of the factors which result in tissue damage in low tension as well as in primary wide open angle glaucoma. Postural behaviour of lOP was therefore studied in 58 normal and 30 glaucomatous Malaysian eyes. Clinical significance and possible pathogenesis of abnormal postural response of lOP has been discussed. More application of this simple procedure is advocated.
Selected students were subjected to a general health appraisal including vision and hearing tests by teachers, nurses and finally a medical officer. The findings of all three examiners were then compared taking the results of the medical officer as the indicator of accuracy. The findings of the survey indicated that the problems of school children were similar to those reported by other workers and by MCH Division of the Ministry of Health namely dental caries, head lice, malnutrition, skin infections and visual disability. Other problems like skeletal deformity and abnormalities of heart, lung, speech and behaviour were extremely uncommon and formed only 1.5% of the total. Teachers and nurses performed extremely well in relation to the doctor with 93% and 95.8% concurrence respectively in detecting these abnormalities. Teachers were also requested to give a feedback on their view of and role in the SHS as well as problems faced in following the school health card. The majority perceived the SHS as a joint effort between the Ministry of Health and Education and agreed that they had a role to play in the SHS. Many teachers also indicated a willingness to carry out the various tasks in the SHS. The main problem in filling the school health card seemed to be in getting relevant details from parents though over 50% of teachers complained that there were too many details to fill. The role of teachers in the SHS is discussed in the light of the findings of the study and recommendations are made.
MeSH terms: Body Height; Body Weight; Child; China/ethnology; Dental Caries; Female; Health Surveys*; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Lice Infestations; Pilot Projects; School Health Services*; Schools; Skin Diseases, Infectious; Teaching*; Vision Disorders; School Teachers
A case of classical congenital diaphragmatic hernia is discussed. The rare right-sided classical type - incidence of 1 in 30,000 to 1 in 81,000 live births - and diaphragmatic eventration are often grouped together as Congenital Diaphragmatic Herniae. We had nine in 57,783 live births in ten years.
Recent developments in breastfeeding are reviewed in relation to species-specific adaptive suckling and the level of maturity of the newborn. Scientific advantages and advances are noted concerning biochemistry, protective substances, emotional differences, child spacing and economics. The significance of unimpaired maternal reflexes and the need for information is stressed with regard to successful lactation and as common causes of inadequacy. The components needed in varying degrees, in breastfeeding programmes are mentioned briefly.
Modern concepts concerning the development of breastfeeding programmes are given, with special reference to maternal reflexes, the need for information and the health and nutrition of mothers. Motivation and education are needed for health professionals, families and administrators. Some successful programmes are mentioned including small-scale hospital activities and national programmes, notably the one developed in Brazil.
MeSH terms: Brazil; Breast Feeding*; Female; Health Education*; Humans; Pregnancy
A child's growth achievement depends on his genetic endowment and the environment in which he lives; Comparative studies of children of similar racial origin but growing under different environmental conditions have shown differences in their body size and shape. In general higher income families produce offspring with higher mean birth weight. This is largely due to better nutrition and care of mothers during pregnancy and childhood. Children from higher socioeconomic groups are on an average larger in size in terms of weight, height, head circumference, midarm circumference, crown-rump length and leg length. This is largely due to a better home environment including sanitation, nutrition, health and care enjoyed by the better-off children. .Generally urban children are larger than rural children mainly due to economic differences between the two areas. In most countries the secular trend to children getting larger still continues reflecting an improvement of living conditions with time. Unlike body size, body shape is less influenced by the environment and the change in body proportion brought about by environment is not permanent. In developing countries, children from higher socioeconomic families have generally thicker skinfolds. On the average, infants and preschool children of European ancestry have thicker triceps skinfolds compared with Negroes and Asians living in comparable environments. It is possible that this is due to long term adaptation to different climatic conditions.
Problems with assessing the effect of maternal nutrition and lactation performance are presented in relation to a conceptual mathematical ziggurat. Difficulties, variations and flows are to be found in stages of this sequence of "logic" [e.g., assessment of maternal nutrition, volume and composition of breast milk, nutritional satisfactions of the nursling). It is concluded that the various steps in this process of reasoning are subject to much more variation and adaptation than appreciated. Much so-called "faltering" in the second trimester is physiologically normal ("pseudo-faltering").
MeSH terms: Body Height; Body Weight; Diet; Female; Humans; Infant; Infant, Newborn; Lactation/physiology*; Male; Nutritional Physiological Phenomena*; Nutritional Requirements; Pregnancy
Various key aspects needing consideration in primary health care services for children are described. These include the need for basic curative facilities, a dyodic approach, concentration on major issues, use of appropriate technology and cultural appropriateness.
MeSH terms: Breast Feeding; Child Health Services*; Cultural Characteristics; Female; Humans; Pregnancy; Primary Health Care*
The role of breastfeeding in preventing malnutrition is considered in relation to the Bostock classification of early human development, its relevance to different forms of malnutrition and to general ecological considerations, including economics and the management and prevention of diarrhoea.